NEWSLETTER 

Volume 2, Issue 49 - December 9, 2022

Pharmacy Issues?

California Prescribing & Medication Filling Issues 

The American Psychiatric Association (APA), CSAP and California's District Branches (CCPS, NCPS, SCPS, OCPS, SDPS) have recently received reports from members regarding growing difficulty of filling prescriptions for controlled substances and the unusual investigative activities of physicians by regulatory boards that seem to be related or triggered by prescription of controlled substances. To further understand these issues in California and ways to address them, CSAP and the DBs seeks input and examples from members. It uses condition logic so that you only get certain questions if you respond affirmatively to others. If you don't want to go through all the options, this is the outline:
 
Your information
Name
Email 
District Branch *Multiple choice
Practice city or zip code 
 
What is the general issue? *Multiple choice

•       Unusual investigations by the California DOJ and/or the medical board related to controlled substances.
  •    Investigating entity *Multiple choice
    •   Cal DOJ
    •   Medical Board of California
    •   Other
  •    Please describe the incident (investigating entity if not Cal DOJ or MBC, stated or suspected reason, other details) Short answer text
•       Pharmacy refusal to fill medications (controlled substances or other psychotropic medications)
  •    Medication prescribed *Multiple choice
    •   Adderall
    •   Non-Adderall stimulant
    •   Benzodiazepine
    •   Other controlled-substance (schedule II-IV)
    •   Non-controlled psychotropic medication (schedule V)
  •    Pharmacy *Multiple choice
    •   CVS
    •   Walgreens
    •   Rite-Aid
    •   Mail-order service
    •   Other
  •    Pharmacy identified issue *Multiple choice
    •   address considerations
      •        Is patient in a different state? *Multiple choice
        •    Yes
        •    No
      •        Patient's city or zip code Short answer text
      •        Pharmacy city or zip code Short answer text
    •   medication dispensing quota or limit
    •   medication shortage
    •   requesting physician provide medical records or a plan for taper
    •   CURES-related concerns
    •   Other
•       Other or additional issues and considerations Short answer text

35: The number of new legislators, including Assembly members moving to the Senate (or in the case of Janet Nguyen, returning), meaning nearly a third of seats feature fresh faces.

62 and 32 : The number of Democrats in the Assembly and the Senate, respectively. That puts Assembly Democrats 8 votes above the two-thirds threshold and Senate Dems 5 over.

51: The number of women legislators — an all-time high but still short of the 60 seats needed for gender parity. Speaking of diversity: We count at least 12 LGBTQ legislators; 12 African-American lawmakers; 37 Latino lawmakers; 13 API lawmakers.

*(note: two races remain undecided. We are counting with current totals that have Democratic Sen. Melissa Hurtado surviving a challenge from Republican David Shepard — Hurtado took a 12-vote lead on Friday — and Republican Greg Wallis edging Democrat Christy Holstege).
 

The California Health and Human Services Agency (CalHHS), in collaboration with its partners at the Department of Health Care Services (DHCS) and the Judicial Council of California (JCC), will be sharing a webinar with general information and important updates on the implementation of the Community Assistance, Recovery & Empowerment (CARE) Act. The recorded webinar will be posted on the CARE Act website on December 19th. 

The webinar will cover: 

• An overview of the CARE Act, based on the enacted law SB 1338 
• Discussion of Frequently Asked Questions about CARE 
• Updates on implementation activities 
• Information about upcoming CARE implementation activities 

CalHHS will establish a CARE Act Working Group in early 2023 and will continue its ongoing engagement with representatives from a wide variety of networks, including peers, disability rights organizations, families, racial equity advocates, housing and homelessness stakeholders, behavioral health providers, associations, and more. 
 

CMA Update

New Laws

We want to make sure you have all seen CMA's new laws report and highlight AB 1278 (Nazarian) which will soon require physicians to provide notice to their patients regarding the Open Payments database, which is managed by the U.S. Centers for Medicare & Medicaid Services, or CMS. 

Specifically, this new law requires physicians to do the following beginning January 1, 2023:

1. At the initial office visit with their patient, a physician must provide either a written or electronic notice of the Database that includes the following text:
   
   “The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov.”
   
   If the physician uses an electronic records system, they must include a record of this notice in the patient’s records.
   
   If the physician uses a paper-based records system, then the written notice to the patient must include a signature from the patient (or their representative) and a date of signature. Further, a copy of the written notice must be provided to the patient (or their representative) and included in the patient's records.
    
2. Post a notice regarding the Database at each location where the physician practices, in an area likely to be seen by all persons. That notice must include an internet website link to the Database and the following text:
   
   “For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.”
   
   If a physician is employed by a health care employer, that employer is responsible for meeting this requirement.

Beginning January 1, 2024, a physician who uses a website in their medical practice must conspicuously post the same notice described above in number 2 on their website. If a physician is employed by a health care employer, that employer is responsible for meeting this requirement. Under this law, a violation of these requirements constitutes unprofessional conduct. The requirements created by this law do not apply to a physician working in a hospital emergency room. For additional information, please see the text of AB 1278.
 

• “Evaluation, Management Coding, and Documentation – What All Psychiatrists in Clinical Practice Need to Know” l Webinar (December 8^th, 2022)
• ”Climate Change-Driven Mental Health Inequities” l Webinar (December 13^th, 2022)
• APA National Election Voting Begins | (January 3^rd, 2023)
• APA National Election Voting Ends | Deadline (January 31^st, 2023)

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• A hard look at New York’s controversial new approach to the homeless
• APA: The Psychiatric Bed Crisis in the US: Understanding the Problem and Moving Toward Solutions
• Taking more seats at the table: In progressive California, women make significant gains in the Legislature
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• Schools turn to telehealth as student mental health crisis soars
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• Could WA follow NYC’s footsteps and force people into mental health treatment?